The 3 Most Common Challenges People Have Qualifying for Medicaid Benefits

Author

Legacy Navigation

Posted on

Oct 12, 2022

CHALLENGE #1:
Knowing How to Fill Out the Complex Medicaid Application
Medicaid eligibility can be incredibly complex and each waiver can differ from state to
state. The consequences of being denied by Medicaid is frustrating and causes undo
stress to clients and families.  
Because the rules for Medicaid change frequently it's difficult for
people to know how to fill out the application properly.  
Additionally, the application is time-consuming and the review process is often lengthy.
As Certified Medicaid Planners Legacy Navigation helps you:
Structure your financial resources
Prepare documentation
Assist in creating Miller trusts
Manage your asset transfers
Preserve your family's resources
Protect your home from Medicaid recovery
Manage your finances to ensure a (a non-applicant spouse) has adequate
income and resources to continue living independently during and after the time
their partner is receiving care assistance.
CHALLENGE #2
Understanding the Latest (and Often Changing) Medicaid Rules and How They Apply to
Your Specific Situation
Do you need to make more monthly income that exceeds Medicaid’s limit?
Are you wondering if you can keep your home?
Do you need a vehicle?
These are conversations Legacy Navigation has everyday with their Clients.  Their
Registered Nurse (RN) and Master Social Worker (MSW) begin the process with a free
consultation to look at your whole picture.  This consultation includes:
● A complete medical, financial, and psychosocial assessment.
● Setting Client & family goals.
● Assessing your likelihood of Medicaid approval.
● Dispelling the myths of Medicaid.  
Once a Client of Legacy Navigation, they will become your Authorized Representative to
gather all the needed paperwork for submitting your formal application to Medicaid.
Once submitted they then go to work communicating with Medicaid 2 to 3 times a week
to ensure your application is moving forward!
CHALLENGE #3
Housing: Finding You Assisted Living or Bringing Care Giving Services to Your Home
Do you want to stay in your home but need more care?
Is it time to consider assisted living but you cannot afford it?
Legacy Navigation has relationships with agencies throughout the State to help with
your Medicaid assisted-living placement, or, finding Medicaid caregivers to provide
support in the home for your advanced care needs.
About Legacy Navigation
Legacy Navigation are skilled pro's in "navigating" the complex world of Medicaid. With a
combined 50 years of health care experience and over 227+ successful Client
placements they are your trusted advocates. Their chief aim is to bring you peace of
mind and comfort during your time of need!
  
Legacy Navigation Is Recognized as Experts in
Medicaid Applications with a 99% Approval Rate
Editor’s Note: This article was submitted by Brooke Baker RN and Jessica Young MSW,
co-owners of Legacy Navigation who may be reached at (208) 204-6004 or on the web
at www.legacynavigate.com

Other Articles You May Like

Medicare/Medicaid/Insurance in Lafayette, CO

When an older adult needs help at home and sees several clinicians, a coverage decision can affect everything from prescription refills to rides. If youre considering TRU PACE in Lafayette, start by asking how enrollment would change the care and coverage you already use. How Medicare and Medicaid Fit Into PACEPACE is the Program of All-Inclusive Care for the Elderly. It coordinates healthcare and support for eligible adults who meet a state standard for nursing home-level care and can live safely in the community with PACE support at enrollment. Applicants must also be 55 or older and live in the programs service area.  TRU PACE and Your Current CoveragePhone: 303-665-0115Medicare says people with Medicaid pay no monthly PACE premium. Medicare beneficiaries without Medicaid pay premiums for the long-term care portion and Medicare Part D drugs. Medicare also says participants owe no deductible, copayment, or coinsurance for drugs, services, or care approved by their PACE team. Ask TRU PACE for an estimate based on your individual coverage before enrolling.  Doctors, Prescriptions, and Existing ServicesTRU PACE says it becomes the participants insurance provider at enrollment. Participants generally receive care through the programs provider network. Bring a list of your doctors, medications, and scheduled services. Ask which providers are in the network and how the team would coordinate any changes.  Why This Matters in LafayetteIf you regularly see a clinician near home or have a specialist visit scheduled outside Lafayette, give the enrollment team the names and dates. Ask which appointments can continue and what to do about any refill due around the enrollment date. How to Get Started1. Gather Your Coverage InformationHave your Medicare and Medicaid information, if applicable, along with details of any current plan. List the appointments and prescriptions you rely on most.2. Ask for an Enrollment and Cost ReviewCall TRU PACE and ask for your expected monthly cost, when any coverage change would take effect, and who would help coordinate the transition.  Related Seniors Blue Book CategoriesPACE Adult Day Services Care Management

Financial Services in Boulder, CO

A move, a change in care needs, or the loss of a spouse can turn a familiar retirement budget into a list of new decisions. Before meeting with a financial professional, identify the question you want answered. You might need to understand what a move would do to your monthly expenses or how much flexibility you have if care costs rise.What Financial Services CoverFinancial services can include financial planning, investment advice, insurance, or help with other money decisions. The scope depends on the professional and the firm. If your immediate question is about paying an overdue bill or applying for a public benefit, a local assistance program may be the better first call. If youre weighing how to use savings or investment accounts over time, ask whether an adviser can address that specific question. Jetty Financial - Rich GaldieriPhone: 303-710-5015Richard Galdieris public professional profile identifies Jetty Financial. The SECs Investment Adviser Public Disclosure database identifies him under CRD number 8206153 with Global View Capital Management LLC in Lafayette, Colorado. Ask which firm would provide the service and appear on your written agreement. The firms name gives you the information you need to review the right disclosures and direct follow-up questions.  Ask What the Engagement IncludesDescribe the decision youre facing and ask what the professional can provide in writing. That may mean a one-time review, a planning engagement, or ongoing investment management, depending on the firms services. Ask which fees apply, how they are calculated, and whether any products or third parties carry separate costs. Investor.gov offers a tool to check registration and review relationship disclosures.  Why This Matters in BoulderIf youre deciding whether to stay in your Boulder home or move closer to family, use actual costs for both options. For your current home, pull recent bills for taxes, insurance, maintenance, and any paid help. For a move, gather quotes for housing and services you expect to use. Put one-time expenses, such as moving or preparing the house for sale, on their own list so you can compare recurring costs clearly.How to Get Started1. Put Your Main Question on One PageList income sources, regular expenses, and the change you expect in the next year. Bring rough figures to an introductory conversation and ask how the firm handles confidential documents before sending account statements.2. Confirm Fees and ResponsibilitiesAsk who will work with you, what you will receive, and how much the engagement is expected to cost. If you are considering ongoing services, ask how often you would meet and what happens if you end the relationship.3. Take Time to Review the AgreementRead the written scope and fee terms before deciding. If your question also involves taxes or legal documents, identify which parts you should take to a tax professional or an attorney. Related Seniors Blue Book Categories Financial Services Elder Law Estate Planning

Financial Assistance in Boulder, CO

A utility bill can be manageable one month and hard to cover the next. If youre living on a fixed income or helping an older family member sort through overdue notices, start with the bill or expense that has the closest deadline. The City of Boulders Older Adult Services case managers can help eligible residents understand what assistance may be available and where to apply.What Financial Assistance Can Help WithFinancial assistance programs help eligible households cover essential expenses or connect with resources that reduce those costs. Programs may address a one-time problem, such as a bill that came due unexpectedly, or an ongoing need, such as difficulty paying for groceries. Each program sets its own rules and deadlines. A case manager can help you identify which applications are worth pursuing.City of Boulder Older Adult ServicesPhone: 303-441-4388 The citys Older Adult Services team works with Boulder residents age 60 and older and their caregivers. Case managers provide information and referrals, help people understand available options, and offer short-term case management. The city also provides financial assistance for eligible clients. Its published screening criteria include age, residency, income, and the type and circumstances of the request. What to Bring Up on the First CallDescribe the immediate problem in plain terms. I received a shutoff notice with a date next week gives a case manager a clearer starting point than I need help with bills. If the same expense has become hard to cover every month, say so. That gives the case manager a chance to discuss ongoing resources as well as any immediate options.Why This Matters in BoulderA Boulder mailing address and residence within Boulder city limits can mean different things for eligibility. If youre unsure whether your address qualifies, give the case manager your street address before gathering paperwork. Older adults who live elsewhere in Boulder County can start with the countys Area Agency on Aging for help identifying resources that serve their address.  How to Get Started1. Find the DeadlineHave the most recent bill or notice handy. Write down the amount due, the due date, and any shutoff date or other deadline shown. Tell the case manager about the deadline at the beginning of your call.2. Ask What Documents You NeedCall 303-441-4388 and ask which documents the city needs for your particular request and how to submit them. Keep copies of any application and the name of the person you spoke with.3. Confirm the Next StepBefore you hang up, ask who will follow up, how to check the status, and whether there is another program to contact in the meantime. If you are calling for someone else, ask whether they need to join the call or give permission for staff to discuss their application. Related Seniors Blue Book Categories Area Agencies on Aging Care Management Care Coordination

Local Services By This Author

Legacy Navigation

Medicaid Planning

*CERTIFIED MEDICAID PLANNERSA Certified Medicaid Planner (CMP) has expert-level experience with Medicaid programs and can help people navigate both current and new Medicaid rules.  A CMPs goal is to give you the most cost-effective and legal plan thats the best fit for your Medicaid situation. Not everyones Medicaid path is the same. A CMP should help you navigate your specific Medicaid strategy as well as implementing that strategy. Medicaid isnt one-size-fits-all, and what someone else qualifies for might not be the best fit for you. As your Medicaid Planners, we complete the application for you, submit all your documents, complete all communication with the state, and take the weight off your shoulders as we guide you through the process to secure resources for the care you need.  FIND OUT MORE*ADVANCED DIRECTIVESHaving a Power of Attorney for medical and financial decisions if you become incapacitated is one of the best planning tools you can use.  These documents allow another to speak for you in the case you can not speak for yourself.  Our team will educate you on your choices and help you complete your power of attorney for healthcare and finances per your wishes.  *FREE IN-HOME CONSULTATIONSOur Registered Nurse and Master Social Worker will visit your home, discuss your options for healthcare and finances, and assist you in making the best plan for your future goals and needs. *ASSET PROTECTIONAs Medicaid Planners, we help clients structure their financial resources and prepare documentation to ensure the greatest possibility of being accepted into the Medicaid program. We manage asset transfers and provide guidance on converting countable assets into exempt assets to ensure eligibility and preserve a familys resources. In many instances, we can also protect a family home from Medicaid recovery. In addition, we manage finances to ensure a healthy spouse (a non-applicant spouse) has adequate income and resources to continue living independently during and after the time their partner is receiving care assistance. When Legacy Navigation becomes involved in the life of a client, whether you are the client or a family member you can expect the following: Increase in client safety and longer lengths of stay in their home environment.  Clinical and professional plan of care that will provide direction for all aspects of care including financial, psycho-social, and medical. Fewer emergencies or hospitalizations for clients with hands on in home visits with both MSW and RN.  Reduced stress for family members with better communication and improved relationships. Visitation and less isolation for clients.  A knowledgeable clinician to assist at MD appointments with information sharing, disease management, and medication management.